Cervical scraper



May 24, 1949. J. E. AYRE I 2,471,088

' CERVICAL SCRAPER Filed Oct. 1, i947 NULL/1 4K006 TYPE 0R ERODED 0FC'ERI/IX (FRI/IX INVENTCJFL JAMES ERNEST AYRE ATTORNEY Patented May 24,1949 [TED STATES CERVICAL SCRAPER Application October 1, 1947, SerialNo. 777,218

1 Claim.

My present invention relates in general to an improved and novel scraperfor use in spatula cytology technique, and more specifically to animproved scraper for use in selective cytology employed in the diagnosisof any accessible surface cancer.

The selective cytology technique was developed in a search for a methodof studying evidence of cancer growth in the cells which become earliestinvolved in cervical cancer. The squamous cells encircling the tinycervical opening at the squamo-columnar junction constitute a key pointof origin for cancer more frequently than any other single focus in thefemale body. The scraper test offers a technique providing surfacebiopsy information of these cells prior to their actual desquamation.The idea is to detect evidence of the earliest cell change in malignancyand of precancerous cell changes. It must be emphasized that thesurgical biopsy is dependent for success upon the lesion being visuallydemonstrable. Numerous cases have been encountered. where a singlebiopsy missed the growth while repeat sections revealed a small cancer.By study of cells in selective cytology smears, morphologic changes havebeen identified believed to constitute a precancer cell-complex. Throughearly diagnosis of cancer by routine cytology tests, death from cancerof the cervix should become highly preventable.

One of the important objects of my present invention is to provide anovel and improved scraper of particular advantage in the selectivemethod for obtaining surface biopsy from the squamo-columnar junction ofthe cervix, and of general advantage in the diagnosis of any accessiblesurface cancer, e. g., tongue, lip, throat, skin and vulva.

Another important object of my invention is to provide a cervicalscraper which is generally elongated in configuration and possesses adegree of flexibility, the scraper having one end thereof constructed totake a smear of a nulliparous type of cervix, while the opposite end isconstructed to be adapted for a parous or eroded type of cervix.

A more specific object of my invention is to provide a thin elongatedscraper, one end thereof having the form of a broad blade of uniformwidth, while the opposite end generally has a pair of divergentprotuberances whereby one of them functions as a pivot for the other asit is rotated during gentle scraping of the entire squamo-columnarjunction throughout its circumference.

Still other objects of my invention will appear as this descriptionproceeds, it being emphasized that my present scraper is extremelyeconomical in manufacture thereby to make entirely practical a simpleoflice test for uterine cancer diagnosis.

In the drawing:

Fig. l is a full size front view of a scraper constructed in accordancewith my invention;

Fig. 2 is a section taken along line 2-2 of Fig. 1 looking in thedirection of the arrows;

Fig. 3 is an end view of the spatula viewed from the blade end;

Fig. 4 shows the manner of using the hook end of the scraper; and

Fig. 5 illustrates the use of the broad blade end of the scraper.

Referring now to the accompanying drawing, the scraper is generally ofthe configuration depicted in Fig. 1. The intermediate section I of theelongated scraper is a narrow thin strip of generally rectangular shape.One end of the strip 1 is formed into a broad blade or paddle 2 whosesides are parallel, and whose leading edge 2-3 is arcuate. The oppositeend t of the strip 1 is essentially heart-shaped in that it comprises apair of divergent protuberances or rounded peaks 5 and 6. Theprotuberance 6 is larger than its mate, and extends beyond it. Thearcuate valley or concavity 1 between the peaks or convex sections 5 and6 functions as a scraping edge. The concave and convex sections 1 and 6function as a scraping edge. The entire strip is made of thin wood, butmay be pressed from a plastic material, or a pulp material such ascardboard. The scraper may, also be made of metal. The scraper isdisposable after use for obtaining a surface biopsy. It will be notedthat the edges of the section t are rounded. The width of blade 2 issomewhat less than the width of section 4.

The method of taking a cervical smear for selective cytology requiresfirst the adequate exposure of the cervix with a bivalve speculum. Themucus present at the external as is aspirated using a small glasspipette, or it may be wiped on" with a cotton swab and discarded. In allcases we take both the external os smear by aspiration and the scrapersmear for selectivity. In these cases the aspirated mucus is placed on aslide for the usual staining procedure, preceding the taking of thescraper test. Following the removal of excess mucus, the squamo-columnarjunction is visualized. The precise method of taking the scraper testwill vary according to the type of cervix, e. g., the presence ofextensive lacerations or erosions will modify the procedure.

A nulliparous or healthy-appearing cervix showing the squamo-columnarjunction just outside the circle of the cervical opening may readily beapproached by simply placing the end 4 of the scraper gently against thecervical opening. Reference is made to Fig. 4 which shows the manner ofusing the section 4 for a nulliparous type of cervix. The, extensive,peak 6 is gently posi-. tioned, as shown, against the cervical opening8. While held in this position a rotary movement, indicated by thecircular arrow, permits light scraping of the entire squamo-columnarjunction 9 throughout its circumference. By rotating the scraper theentire circumference of this cancer zone may be surface biopsied. fromthis key point show the earliest indication of incipient carcinomabefore any lesion may be recognized by the naked eye. The hook end 4 isnot suitable for cervices with long erosioris,v as the scraping mightmiss the. squamous tissue, obtainng. a. fsurfa e biopsy of landulartissue only.

Barons. cervices. more commonly exhibit a larger portion oi th dd shlandular cerv a p thelium. with or without an erosion, eversion orlaceration. For cervices of this type the scraper test is taken byscraping along. the squamo-columilar marg n at the most suspicious areawith the other end 2 of the scraper. This. is shown ii -Fig. whichdepicts the. manner of using the end 2. The. scraper is rotated in thedirection of the. arrow. Whether the secretion is derived as shown inFig, 4 or Fig. 5 it is spread over a glass slide. and th n process d to.pre erve. in a glyoe media for 7-14 days so as to submit to. anyspecial-.

The c lls. shed ized cytological laboratory for experiencedinterpretation.

In summary, from a cytological study of over 3000 cases, by the use ofcervical cytology tests in general and the scraper technique inparticular, death from carcinoma of the cervix could potentially becomehighly preventable. It would appear that lay routine cervical; cytologytests With a scraper of the present type it, becomes more practical andeasier to take advantage of the life-saving possibilities offered bycytology.

What I claim is:

A cervical scraper consisting of an elongated strip, one; end of the.strip being generally triangular and having a pair of unsymmetricalconvex end sectionsoonnected by a section of concave configuration, oneof said convex sections being substantially longer than the other, andsaid longersection being adapted to enter the cervical opening andfunction as a pivot, the shorter section functioningas. a, rotatablewing relative to said. pivot, said concave section being adapted toscrape cells from the. squamowolumnarjunction inresponse to. rotation ofthe scraper about the Pivo aflorde y said. longer section.

JAMES ERNEST AY'RE'.

REEERENQES C TED The fol-lowing references are of: record in the file ofthis patent;

Catalog of George Pilling- 8: Son Co. of Philadelphia, published in1921, page 122-. (Copy in Division 55.)-

